Article 2: Long-Term Employment Outcome in Adults With Pediatric-Onset Spinal Cord Injury

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2008 ACRM Annual Conference Abstracts Provided here are the abstracts of scientific papers and posters presented at the joint 85th Annual Conference of the American Congress of Rehabilitation Medicine (ACRM) and the 15th Annual Conference of the American Society of Neurorehabilitation (ASNR), in Toronto, ON, Canada, October 15–19, 2008. Papers and posters were chosen by the joint ACRM–ASNR program committee. The abstracts have not been subjected to formal peer review by the Editorial Board of the Archives of Physical Medicine and Rehabilitation. Abstracts from the 2008 ACRM–ASNR Joint Conference are published in both society journals: Archives of Physical Medicine and Rehabilitation, 2008;89(10):E1-55, and Neurorehabilitation and Neural Repair, 2008;22(5).

Paper Presentations Article 1 Attitudes Toward Elderly Individuals With Traumatic Spinal Cord Injury Among Registered Nurses: A Cross-Sectional Study. Julio C. Furlan (Toronto Rehabilitation Institute, Toronto, ON), B. Catharine Craven, Michael G. Fehlings. Disclosure: None declared. Objective: To examine potential factors that may influence attitudes toward elderly individuals among registered nurses caring for individuals with traumatic spinal cord injury (SCI). Design: Cross-sectional study. Setting: 2 tertiary care SCI units (acute care, rehabilitation). Participants: Registered nurses. Intervention: Kogan’s Attitude Toward Old People (KOP) questionnaire was administered to registered nurses. Main Outcome Measure: The KOP includes 17 negatively framed (KOP⫺) and 17 positively framed questions (KOP⫹). Age, regularity in caring for SCI patients (weekly, monthly, sporadically, never), experience, time, education, and work settings were assessed as potential covariates. Results: Among women respondents (response rate, 37%), there were 12 registered nurses from rehabilitation center and 14 registered nurses from acute care unit. Respondents’ mean age was 39.6 years (22–59y). Univariate analyses showed no significant differences for KOP⫹ in comparison with settings, regularity, or experience. Higher education level was significantly associated with greater KOP⫹ (P⫽.006). There was a trend toward association between older registered nurse age and greater KOP⫹ (P⫽.068). There was no significant effect on KOP⫺ of age, regularity, or experience. KOP⫺ significantly differed between both settings (P⫽.015). Higher education level was significantly associated with greater KOP⫺ (P⫽.035). Conclusions: Greater levels of education for registered nurses positively influence attitudes toward elderly SCI patients as represented by higher KOP⫹ and KOP⫺ scores. Our study results suggest that specialized nursing training may overcome the potentially negative impact of ageism. Key Words: Aging; Rehabilitation; Spinal cord injuries; Treatment outcomes. Article 2 Long-Term Employment Outcome in Adults With Pediatric-Onset Spinal Cord Injury. Yuying Chen (University of Alabama, Birmingham, AL), Caroline Anderson, Lawrence Vogel. Disclosure: None declared. Objective: To examine the stability of employment after spinal cord injury (SCI). Design: Prospective dynamic cohort study. Setting:

Community. Participants: People who sustained an SCI before age 19 years were initially interviewed at age 24 years or older and followed using a structured telephone interview on an annual basis, from 1996 to 2006. Interventions: Not applicable. Main Outcome Measure: Self-reported employment status. Results: A total of 1171 interviews were conducted among 184 men and 94 women (89% white; age, 27.1⫾3.4y; time since injury, 12.8⫾4.9y, follow-up, 4.1⫾2.3y). The life table analysis estimated that 31% (n⫽151) of subjects who were initially unemployed would become employed in 5 years. Approximately 69% (n⫽127) of those who were employed at baseline would remain employed in 5 years. The generalized estimating equations model showed the odds of being employed over the course of follow-up were significantly higher for white, married, paraplegic subjects, and those with college degrees. After accounting for baseline employment status, only education level remained significant in determining employment over time. Conclusions: This study suggests a positive impact of education on the stability of employment over time. To improve the employment rate among adults with pediatric-onset SCI, education could be targeted for intervention. Key Words: Employment; Rehabilitation; Spinal cord injuries. Article 3 The Effects of Functional Electric Stimulation Cycling for Children With Spinal Cord Injury. Therese E. Johnston (University of the Sciences, Philadelphia, PA), Brian T. Smith, M.J. Mulcahey, Randal R. Betz, Richard T. Lauer. Disclosure: None declared. Objective: To determine the musculoskeletal and cardiovascular effects of cycling with functional electric stimulation (FES) for children with spinal cord injury (SCI). Design: Before-after intervention trial. Setting: Pediatric referral hospital. Participants: A convenience sample of 9 children, ages 9.0⫾2.1 years, with C4-T11 motor complete SCI of 4.8⫾2.1 years in duration. Intervention: Children exercised with an FES cycle for 1 hour, 3 times a week, for 6 months at home. Stimulation was provided to the quadriceps, hamstrings, and gluteal muscles during cycling. Main Outcome Measures: Measures included stimulated quadriceps and hamstrings isometric muscle strength, hip and knee bone mineral density (BMD), peak oxygen uptake (Vo2peak) during progressive upper-extremity ergometry testing, and a fasting lipid profile. Data were analyzed using 1-tailed paired t tests due to directional hypotheses. Results: Children comArch Phys Med Rehabil Vol 89, October 2008